Background SLE is characterized by the production of a wide range of autoantibodies and immune complexes that may lead to tissue injury. Among patients with Lupus Nephritis; those with proliferative lesions (class III and IV) had higher serum NO levels, and higher NO levels were associated with accumulation of renal damage
Objectives Assess the level of serum Nitric oxide (NO) inLN patients and its relation to disease activity.
Methods The study was conducted on:
– Group I (A): 20 SLE patients without clinically apparent renal disease.
– Group I (B): 20 SLE patients with lupus nephritis.
Besides: 10 of age and sex matched healthy subjects were taken as control group. All patients were subjected to: detailed history taking and complete physical SLE Disease Activity Index (SLEDAI), and SLE disease damage index (SLEDDI) were applied for every lupus patient of the studied groups Laboratory investigations done for the studied group of patients included:
– C3, C4, antinuclear antibodies (ANA) titre, antidouble stranded DNA antibodies (anti-ds DNA) titre, and serum Nitric Oxide.
Renal biopsy in all the 20 cases with renal involvement were obtained – after an informed consent, and classified according to the International Society of Nephrology/Renal Pathology Society (ISN/RPS) 2003, and was correlated with the serum level of NO.
The mean serum Nitric oxide level was significantly higher in patients with renal involvement compared to those without renal involvement. It is also significantly higher in SLE patients than controls.
The serum Nitric oxide level was correlated positively with ESR, anti ds-DNA antibodies level, 24 hr. urinary proteins, SLEDAI and pathological activity score in LN group, and showed negative correlation with creatinine clearance and serum level of C3 and C4. There was no significant correlation between serum NO and pathological chronicity score in LN group.
There was no significant statistical difference between classes of Lupus nephritis as regards the mean value of serum Nitric oxide, although it was found to be higher in proliferative classes of Lupus nephritis (class IV and combined class IV and V) than non-proliferative
Conclusions serum Nitric oxide can be used as an indicator for renal disease activity in SLE patients, and that it can be used in association with renal biopsy for estimating the class of renal involvement, correlation with renal disease activity
Jim C. Oates, Stephanie R. Shaftman, Sally E. Self and Gary S.Gilkeson. Association of serum Nitrate and Nitrite levels with longitudinal assessments of disease activity and damage in Systemic Lupus Erythematosus and Lupus Nephritis. Arthritis Rheum. 2008 January; 58(1): 263–272.
Seok and Yun A. Kim. Correlation of serum Nitric oxide levels and disease activity of Systemic Lupus Erythematosus. Chonnam Medical Journal, Vol. 37, No. 2, pp. 119-123.
Acknowledgements staff members and colleagues in Rheumatology Department,Alexandria Faculty of Medicine,
Disclosure of Interest None declared
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